Healthcare Provider Details

I. General information

NPI: 1942506118
Provider Name (Legal Business Name): SUNRISE SENIOR LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2011
Last Update Date: 02/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 JOSEPH SIEWICK DR
FAIRFAX VA
22033-1742
US

IV. Provider business mailing address

3750 JOSEPH SIEWICK DR
FAIRFAX VA
22033-1742
US

V. Phone/Fax

Practice location:
  • Phone: 703-264-0506
  • Fax: 703-264-0620
Mailing address:
  • Phone: 703-264-0506
  • Fax: 703-264-0620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberFLO1079364L152
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License NumberFLO1079364L152
License Number StateVA

VIII. Authorized Official

Name: MS. VALERIE PARKER
Title or Position: DIRECTOR OF COMMNITY RELATIONS
Credential:
Phone: 703-264-2043